A peritonsillar abscess (PTA), also known as quinsy, is a localized collection of pus that develops in the tissues adjacent to one of the tonsils, in the peritonsillar space. This condition is typically a complication arising from a preceding bacterial infection of the throat, such as tonsillitis or strep throat. The abscess creates a painful, swollen mass that can push the tonsil toward the middle of the throat. Because of its potential for rapid growth, a PTA is considered a serious infection requiring immediate medical evaluation and treatment.
Answering the Core Question About Transmission
The peritonsillar abscess itself is not contagious. An abscess is a localized pocket of pus, representing the body’s attempt to wall off an infection in a specific area, and this collection cannot be transmitted from person to person. The confusion stems from the fact that the underlying bacterial infection that causes the abscess is highly transmissible.
The bacteria responsible, most commonly Streptococcus pyogenes (Group A Strep) or other polymicrobial organisms, can spread through respiratory droplets from coughing, sneezing, or close contact. While a person cannot catch the abscess, they can contract the initial bacterial infection that, in rare cases, might lead to an abscess. Practicing good hygiene, like frequent hand washing and covering coughs, helps prevent the spread of the primary infection.
How a Peritonsillar Abscess Develops
The formation of a peritonsillar abscess usually begins with acute tonsillitis, where the tonsils become inflamed and infected with bacteria. If this initial infection is not adequately treated, the bacteria can spread beyond the tonsil capsule into the loose connective tissue of the peritonsillar space, situated between the tonsil and the pharyngeal muscles. This area is highly susceptible to infection and the subsequent accumulation of purulent material.
Another proposed mechanism suggests the abscess originates from an infection in the Weber glands, which are minor salivary glands located in the supratonsillar fossa. Obstruction or infection of these glands, which normally help clear debris from the tonsils, can lead to localized necrosis and pus formation. Regardless of the starting point, the body’s immune response attempts to contain the spreading bacteria, resulting in the characteristic pocket of pus.
Identifying Severe Symptoms Requiring Immediate Care
Recognizing the specific signs of a peritonsillar abscess is paramount because the swelling can lead to life-threatening complications, including airway obstruction. A hallmark symptom is a severe, progressively worsening sore throat that is almost always unilateral. This intense pain often makes it extremely difficult to swallow (dysphagia), and may cause referred ear pain on the same side.
A person with a developing PTA may experience trismus, which is the involuntary difficulty or inability to open the mouth fully due to spasm of the jaw muscles. Their voice often becomes muffled and thick, commonly described as a “hot potato” voice. Upon visual inspection, the soft palate on the affected side is swollen, and the uvula is noticeably pushed away from the swollen tonsil toward the unaffected side. Anyone presenting with these symptoms needs immediate medical attention to prevent the infection from spreading into deeper neck tissues or obstructing the airway.
Treatment Options and Recovery
The standard treatment for a confirmed peritonsillar abscess involves a combination of surgical drainage and aggressive antibiotic therapy. Drainage is performed to immediately relieve pressure, reduce pain, and prevent the spread of infection. This is achieved either through needle aspiration (drawing the pus out) or by incision and drainage (I&D), where a small cut allows the pus to drain.
Following drainage, antibiotics are promptly administered, often intravenously at first, to target the polymicrobial nature of the infection, which includes Group A Streptococcus and various oral anaerobes. The patient is typically switched to a 7- to 14-day course of oral antibiotics once they can tolerate swallowing. Supportive care, including intravenous fluids to combat dehydration and pain relievers, helps manage symptoms and speed recovery. While most patients recover fully, individuals with recurrent PTAs or chronic tonsillitis may be advised to undergo a tonsillectomy to prevent future episodes.